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Individual
MRS. VIVIAN L CONDELLO
Active
Individual
MRS. VIVIAN L CONDELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, FNP, IBCLC
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
252168-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F332995-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RB7031
MEDICARE PTAN
NY
Enumeration date
05/14/2007
Last updated
02/04/2022
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